Medicare Corrects 2020 MIPS Errors, Extends Review Deadline
By Joey Berlin

Many physicians who participated in Medicare’s Merit-Based Incentive Payment System (MIPS) in 2020 are seeing their scores rise – a bit – after Medicare acknowledged and corrected a pair of technical errors by the agency that affected scores for 2020 MIPS participants. As a result, Medicare has extended the deadline to Nov. 29 for you to review your MIPS score for accuracy.

The Centers for Medicare & Medicaid Services (CMS) posted revised scores to the Quality Payment Program (QPP) website following reviews that unearthed two problems with MIPS scoring. CMS’ corrections affect payment adjustments –  incentives and penalties – that participants will receive in 2022 for their 2020 MIPS performance.

The now-corrected errors in 2020 performance scoring are:

  • Accountable care organizations (ACOs) participating in the Medicare Shared Savings Program didn’t receive the “complex patient” bonus, an error that affected every ACO in the program with MIPS-eligible clinicians. “Shared Savings Program ACOs will see up to 10 complex patient bonus points reflected in their performance feedback and added to their final scores, if applicable,” CMS said.
  • The QPP system didn’t recognize patient-reported outcome measures as outcome measures. Correcting that resulted in two potential changes to the Quality performance category for about 30,000 clinicians. “The majority of affected clinicians will see a modest increase in their quality performance category score and MIPS final score as a result of this correction. However, approximately 4,400 clinicians will see a decrease in their quality performance category score and MIPS final score,” CMS said.

Also, the agency says, some MIPS participants who weren’t affected by either of these errors will still see “slight changes” in their 2022 payment adjustment. That’s because MIPS is required to be a budget-neutral program, meaning its payment penalties and incentive payments must balance each other. “As a result of changes to MIPS final scores from these two corrections, we reassessed the associated MIPS payment adjustments to maintain budget neutrality,” CMS said.

The discovery of the two issues came about as a result of the “targeted review” process, which allows clinicians to request a review of their MIPS scores and feedback, CMS explains. The agency has now extended the deadline for requesting a targeted review to Nov. 29 at 7 pm CT.

CMS encourages you to sign in to the QPP website, review your performance feedback, and request a targeted review if you believe an error still exists with your 2020 score/2022 payment adjustment.

The same deadline, Nov. 29 at 7 pm CT, also applies to clinicians who want to request a reweighting of MIPS categories under QPP’s “extreme and uncontrollable circumstances” policy – for example, if your MIPS participation and scoring was affected by the COVID-19 pandemic.

CMS offers the following QPP resources for help:

Direct questions to the QPP at (866) 288-8292 or by email. CMS says nonpeak hours for calling are before 9 am CT and after 1 pm CT. The hearing impaired can dial 711 to be connected to a Telecommunications Relay Service assistant.

Last Updated On

October 06, 2021

Originally Published On

October 06, 2021

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Joey Berlin

Associate Editor

(512) 370-1393
JoeyBerlinSQ

Joey Berlin is associate editor of Texas Medicine. His previous work includes stints as a reporter and editor for various newspapers and publishing companies, and he’s covered everything from hard news to sports to workers’ compensation. Joey grew up in the Kansas City area and attended the University of Kansas. He lives in Austin.

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